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KENNETH M. BURTNER DMD

Oral and Maxillofacial Pathology

Fort Mill, South Carolina

Provider NPI: 1801976162

Provider Information:
 KENNETH M. BURTNER DMD
Gender: M
Sole Proprietor


Practice Location:
105 BEN CASEY DR SUITE 115 FORT MILL, SC 29708 US
Tel: 803-548-9910  Fax: 803-548-9915

Business Mailing Address:
105 BEN CASEY DR SUITE 115 FORT MILL, SC 29708 US
Tel: 803-548-9910  Fax: 803-548-9915

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0106XDental Providers
Dentist
Oral and Maxillofacial Pathology
SC3553/611

Other Provider Identifiers:

IssuerNumberStateType
ZA9491SC05
5903373NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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